Early Atherosclerosis in Pediatric Systemic Lupus Erythematosus: A Systematic Review and Meta-Analysis

IF 2.4 4区医学 Q2 RHEUMATOLOGY

International Journal of Rheumatic Diseases Pub Date : 2025-04-10 DOI:10.1111/1756-185X.70217

Pratap Kumar Patra, Aaqib Zaffar Banday, Adil Asghar, Rashmi Ranjan Das, Pakkiresh Reddy, Priyanka Priyanka, Pallavi Singh, Nutan Sharma, Shagufta Naaz, Rahila Nisar, Dharmagat Bhattarai, Abdus Sami Bhat, Anju Gupta

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引用次数: 0

Abstract

Objective

Adults with systemic lupus erythematosus (SLE) are at a higher risk of cardiovascular complications. Numerous meta-analyses in adults with SLE have consistently demonstrated altered surrogate parameters of atherosclerosis (subclinical atherosclerosis). However, meta-analyses assessing the impact of pediatric SLE (pSLE) on cardiovascular health are lacking. Herein, we perform a systematic review and meta-analysis of studies assessing subclinical atherosclerosis in pSLE.

Methods

Embase, Web of Science, and PubMed databases were systematically searched for pertinent literature published between January 1965 and February 2024. Patients with SLE and healthy participants were included as cases and controls, respectively. Online PICO portal, Newcastle–Ottawa scale, Review Manager and R software, and GRADEpro GDT tool were used for study deduplication and data extraction, study quality evaluation, data synthesis/analysis (including meta-regression), and certainty of evidence assessment, respectively.

Results

A total of 9 studies (out of 126 citations), including 1021 participants (528 cases and 493 controls), were included in the analysis. Carotid intima–media thickness (CIMT) and pulse wave velocity (PWV) were significantly higher in cases as compared to controls [mean difference (MD) 0.04 (95% CI 0.01–0.08) mm, p = 0.007 and MD 0.48 (95% CI 0.02–0.94) m/s, p = 0.04, respectively]. The flow-mediated dilatation was similar in the two groups. Significant heterogeneity was observed for all the outcome measures. On meta-regression analysis, disease duration correlated significantly with both CIMT MD and PWV MD.

Conclusions

A “low”-quality evidence suggests that pSLE may adversely impact vascular microanatomy and physiology. Longitudinal studies are needed to precisely quantify the cardiovascular risk in pSLE.

Registration

PROSPERO (CRD42022323752).

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来源期刊

International Journal of Rheumatic Diseases RHEUMATOLOGY-

CiteScore

3.70

自引率

4.00%

发文量

362

审稿时长

1 months

期刊介绍： The International Journal of Rheumatic Diseases (formerly APLAR Journal of Rheumatology) is the official journal of the Asia Pacific League of Associations for Rheumatology. The Journal accepts original articles on clinical or experimental research pertinent to the rheumatic diseases, work on connective tissue diseases and other immune and allergic disorders. The acceptance criteria for all papers are the quality and originality of the research and its significance to our readership. Except where otherwise stated, manuscripts are peer reviewed by two anonymous reviewers and the Editor.